Could Cuba Help U.S. Fight Tropical Diseases?

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In the wake of this month's Republican electoral shakeup in
Congress, talk of lifting the U.S. travel ban to Communist Cuba
is pretty much off the table. But President Barack Obama still
has the executive power to ease the amount of red tape faced by
U.S. medical researchers who can travel to the island.

For some, such a move might awaken fears of radical socialism,
but others say when it comes to issues like the spread of
tropical and infectious disease from global warming, increased
collaboration with a neighbor is just good medicine.

“I think because of climate change, because some of these
infectious diseases are coming through in epic forms,
collaboration between all countries is more needed than ever,”
said Gail A. Reed, the International Director of MEDICC, an
American non-profit organization working to enhance global health
cooperation with Cuba.

Hepatitis, chikungunya, bird flu and H1N1 are all diseases that
concern U.S. epidemiologists. But dengue fever, the most common
of mosquito-born illnesses, is one of the biggest. This summer,
the Centers for Disease Control reported that five percent of
residents in Key West, Fla. had been exposed to the deadly virus.

Dengue was eradicated in the United States in the 1940s, with
just a few cases creeping across the U.S.-Mexico border in the
1980s. It is endemic to most of the Caribbean, but not to Cuba.
In fact, strong research and preventative measures have won
Havana’s Pedro Kouri Cuban Tropical Medicine Institute special
status as a World Health Organization Collaborating Center for
Dengue Study and Control.

“In that sense, U.S. scientists are very interested in
collaborating with Cuba because they have a history of
investigations and successful research not only into the impact
but the viral origins,” Reed said.

That interest dates to before the 1959 Cuban Revolution that
brought Fidel Castro to power. In 1889, the American Public
Health Association requested that the United States government
annex Cuba from Spain to protect Americans from Yellow Fever.

Panic over the disease helped fuel the 1898 Spanish American War,
says Pedro Orduñez, a Cuban doctor who has published extensively
on U.S.-Cuba medical research in both Washington and Havana.

“Health in Cuba is the icon of the revolution,” noted Orduñez,
explaining that Cuba’s invention of a broad-based primary care
system helped it assert its sovereign identity.

That faltered during the 1991 collapse of the Soviet Union,
Cuba’s main economic backer. Thousands of Cuban rafters set sail
for Florida, and many of the Cubans who remained began to suffer
epidemics such as optic neuropathy, a temporary blindness
associated with certain nutritional deficiencies.

As a result, the U.S. government loosened some U.S. travel and
trade restrictions on humanitarian aid. That, in turn, pried open
collaborative doors a little further, allowing new organizations
such as MEDICC to create U.S.-Cuba medical exchanges. In 2001,
Cuba offered full-ride scholarships for up to 500 U.S. students
at its Latin American Medical School, and the U.S. government
obliged.

Dr. Sitembile Sales, a 2010 U.S. graduate of the Latin American
Medical School in Havana, is grateful both nations allowed her to
access the Cuban government’s medical scholarship. She says it
gave her invaluable training for crises and epidemics anywhere.
During her third year of medicine, she was thrown onto 24-hour
hospital rounds for two dengue fever epidemics.

“There were meetings with our professors saying this is war, we
have an attack … there’s no room for mistakes,” she told
Discovery News. “The good thing is that people never dropped like
flies because we never let them get to that point.”

Obstacles still abound. Sales needed a special student license to
travel to Cuba, and a general license that allows American
professionals to conduct research there is not as general as it
sounds.

Researchers must scrutinize every aspect of their trip to make
sure their spending and collaborative habits do not infringe upon
U.S. sanctions. That means knowing what research equipment they
can carry without a separate license, how much money they can
spend in country and on what, how their work will be disseminated
later, and under what specific contexts they can collaborate with
or learn from the Cuban people.

For example, researchers have to ask for a different license if
they plan to attend a Cuba-sponsored science conference or
workshop, and in Cuba, most events are government run. Obtaining
a U.S. license for conferences or research equipment involves
mounds of paperwork and an answer can take months. Interest
groups say these factors slow down the process of participating
in projects that would otherwise prove to be a quick and
efficient way of obtaining important medical data or learning new
methods for curbing an epidemic.

Earlier this year, the U.S. Congress had seriously discussed a
full lifting of the travel ban, but Cuban-American Congressmen
expressed concerns about Americans fueling a tourism industry run
by the Cuban government. Now researchers say more Republicans in
Congress will further stifle that possibility, but note that
Obama could still ease the licensing needed for more extensive
medical research.

To gauge the likelihood of that possibility, Discovery News
reached out to the White House, as well as to Cuban American
Congressmen Ileana Ros-Lehtinen, R-Fla., Robert Menendez, D-N.J.,
Lincoln Diaz-Balart, R-Fla. and Albio Sires, D-N.J. None
responded.

Jorge Bolaños, the Chief of Mission for the Cuban Interests
Section in Washington, did offer Discovery News some thoughts
following a lecture he gave at nearby Howard University.

“We have no objection to any cooperation,” he said, adding that
his country was very proud of its ability to stave off epidemics
through preventative strategies in spite of serious economic and
material deficiencies.

“If I’m waiting to get the flu shot, and if I don’t go there (to
the clinic) for the flu shot, they will go to my house… When you
don’t go to see the doctor, you suffer the tyranny of the
doctor,” he joked.